R09-107
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2 RESOLUTION NO. R09- 107
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4
5 A RESOLUTION OF THE CITY COMMISSION OF
6 BOYNTON BEACH, FLORIDA, AWARDING A
7 CONTRACT FOR RFP #056-1610-09/CJD "GROUP
8 BENEFITS: MEDICAL CLAIMS ADMINISTRA TOR
9 (TP A) SERVICES AND/OR FULLY INSURED PLANS,
10 FULL Y INSURED DENTAL AND VISION" WITH BLUE
II CROSS/BLUE SHIELD OF FLORIDA, INC., FOR
\2 MEDICAL COVERAGE; AND PROVIDING AN
13 EFFECTIVE DATE.
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16 WHEREAS. on June 29, 2009, Procurement Services received and opened nine (9)
17 proposals which were reviewed by the review committee and sent to the City's Consultant,
18 Willis of Florida for technical expertise; and
19 WHEREAS, the City Commission of the City of Boynton Beach, upon
20 recommendation of staff. deems it to be in the best interests of the residents and citizens of the
21 City of Boynton Beach to award a Provider Agreement with Blue Cross/Blue Shield of Florida
22 medical plan for a one year term commencing October 1, 2009, with three additional one (1)
23 year renewal options for all city employees.
24 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
25 THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
26 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed
27 as being true and correct and are hereby made a specific part of this Resolution upon adoption
28 hereof.
29 Section 2. The City Commission of the City of Boynton Beach. Florida does
30 hereby award a Provider Agreement with Blue Cross/Blue Shield of Florida medical plan for a
S:\CA \RESO\Agreements\BCBS Health Benefits 2009-1 O.doc
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I one year term commencing October 1. 2009, with three additional one (I) year renewal
2 options for all city employees. a copy of which is attached hereto as Exhibit "AU
3 Section 3. The City Manager and City Clerk are authorized to execute the
4 Provider Agreement with Blue Cross/Blue Shield of Florida.
5 Section 4. That this Resolution shall become effective immediately upon passage.
6 PASSED AND ADOPTED this _!l~ay of August, 2009.
7
8 CITY OF BOYNTO~ BEACH, FLORIDA
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14 Vice Maypr - Woodro\\ L. Hay .-.;..1
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] 7 . Commj,ssioner - Rona Weiland
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" Commissioner - Marlene Ross -
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25 ATTEST:
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29 ,1 j J~~et' M. Prainito, /CMC
30 I. , City Clerk
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33 (Corporate Seal)
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S:\CA\RESO\Agreements'.BCBS Health Benefits 2009-1 O.doc
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PROVIDER AGREEMENT FOR
"GROUP BENEFITS: MEDICAL CLAIMS ADMINISTRATOR (TPA) SERVICES
AND/OR FULLY INSURED PLAN, FULLY INSURED DENTAL AND VISION"
THIS AGREEMENT is entered into between the City of Boynton Beach, hereinafter referred to
as "the City", and Florida Combined Life Insurance Companv. Inc. (Blue Cross and Blue
Shield of Florida. Inc.), hereinafter referred to as "the Provider", in consideration of the mutual
benefits, terms, and conditions hereinafter specified.
1. PROJECT DESIGNATION. The Provider is retained by the City to perform PROVIDER
services in connection with the project designated.
2. SCOPE OF SERVICES. Provider agrees to perform the services, identified on Exhibit "A"
attached hereto and incorporated herein by reference, including the provision of all labor,
materials, equipment and supplies. No modifications will be made to the original scope of
work without the written approval of the City Manager or his designee.
3. TIME FOR PERFORMANCE. Work under this contract shall commence upon the giving of
written notice by the City to the Provider to proceed. Provider shall perform all services and
provide all work product required pursuant to this agreement.
4. TERM: October I, 2009 through September 30, 2010 with three (3) additional one (1) year
renewals.
5. PAYMENT. The Provider shall be paid by the City for completed work and for services
rendered under this agreement as follows:
Monthly basis per eligible employee and dependent for medical coverage invoiced by
provider.
6. OWNERSHIP AND USE OF DOCUMENTS. All documents, drawings, specifications and
other materials produced by the Provider in connection with the services rendered under this
Agreement shall be the property of the City whether the project for which they are made is
executed or not. The Provider shall be permitted to retain copies, including reproducible
copies, of drawings and specifications for information, reference and use in connection with
Provider's endeavors.
7. COMPLIANCE WITH LAWS. Provider shall, in performing the services contemplated by
this Agreement, faithfully observe and comply with all federal, state and local laws,
ordinances and regulations that are applicable to the services to be rendered under this
agreement.
8. INDEMNIFICATION. Provider shall indemnify, defend and hold harmless the City, its
offices, agents and employees, from and against any and all claims, losses or liability, or any
portion thereof, including attorneys fees and costs, arising from injury or death to persons,
including injuries, sickness, disease or death to Provider's own employees, or damage to
property occasioned by a negligent act, omISSIOn or failure of the Provider.
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9. INSURANCE. The Provider shall secure and maintain in force throughout the duration of
this contract comprehensive general liability insurance with a minimum coverage of
$1,000,000 per occurrence and $1,000,000 aggregate for personal injury; and $1,000,000 per
occurrence/aggregate for property damage, and professional liability insurance in the amount
of $1 ,000,000 per occurrence to 2 million aggregate with defense costs in addition to limits.
Said general liability policy shall name the City of Boynton Beach as an additional named
insured and shall include a provision prohibiting cancellation of said policy except upon
thirty (30) days prior written notice to the City. Certificates of coverage as required by this
section shall be delivered to the City within fifteen (15) days of execution of this agreement.
10. INDEPENDENT CONTRACTOR. The Provider and the City agree that the Provider is an
independent contractor with respect to the services provided pursuant to this agreement.
Nothing in this agreement shall be considered to create the relationship of employer and
employee between the parties hereto. Neither Provider nor any employee of Provider shall
be entitled to any benefits accorded City employees by virtue of the services provided under
this agreement. The City shall not be responsible for withholding or otherwise deducting
federal income tax or social security or for contributing to the state industrial insurance
program, otherwise assuming the duties of an employer with respect to Provider, or any
employee of Provider.
11. COVENANT AGAINST CONTINGENT FEES. The Provider warrants that he has not
employed or retained any company or person, other than a bonafide employee working solely
for the Provider, to solicit or secure this contract, and that he has not paid or agreed to pay
any company or person, other than a bonafide employee working solely for the Provider, any
fee, commission, percentage, brokerage fee, gifts, or any other consideration contingent upon
or resulting from the award or making of this contract.
For breach or violation of this warranty, the City shall have the right to annul this contract
without liability or, in its discretion to deduct from the contract price or consideration, or
otherwise recover, the full amount of such fee, commission, percentage, brokerage fee, gift,
or contingent fee.
12. DISCRIMINATION PROHIBITED. The Provider, with regard to the work performed by it
under this agreement, will not discriminate on the grounds of race, color, national origin,
religion, creed, age, sex or the presence of any physical or sensory handicap in the selection
and retention of employees or procurement of materials or supplies.
13. ASSIGNMENT. The Provider shall not sublet or assign any of the services covered by this
Agreement without the express written consent of the City.
14. NON-WAIVER. Waiver by the City of any provision of this Agreement or any time
limitation provided for in this Agreement shall not constitute a waiver of any other provision.
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15. TERMINATION.
a. The City reserves the right to terminate this Agreement at any time by giving ten
(10) days written notice to the Provider.
b. In the event of the death of a member, partner or officer of the Provider, or any of its
supervisory personnel assigned to the project, the surviving members of the Provider hereby
agree to complete the work under the terms of this Agreement, if requested to do so by the
City. This section shall not be a bar to renegotiations of this Agreement between surviving
members of the Provider and the City, if the City so chooses.
16. DISPUTES. Any disputes that arise between the parties with respect to the performance
of this Agreement, which cannot be resolved through negotiations, shall be submitted to
a court of competent jurisdiction in Palm Beach County, Florida. This Agreement shall
be construed under Florida Law.
17. NOTICES. Notices to the City of Boynton Beach shall be sent to the following address:
City of Boynton Beach
P.O. Box 310
Boynton Beach, FL 33425-0310
Notices to Provider shall be sent to the following address:
'l,
Florida Combined Life Insurance Company, Inc. (Blue Cross Blue Shield of
Florida)
5011 Gate Parkway, Bldg. 200, Suite 300
Jacksonville, FI 32256
Attn: Hank Reed
18. INTEGRATED AGREEMENT. This agreement, together with attachments or addenda,
represents the entire and integrated agreement between the City and the Provider and
supersedes all prior negotiations, representations, or agreements written or oral. This
agreement may be amended only by written instrument signed by both City and Provider.
DATED this _ day of ,20
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CITY OF BOYNTON BEACH
City Manager Provider
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Attest/Authenticated:
Title
(Corporate Seal)
City Clerk
Approved as to Form: Attest/Authenticated;
n~fice of the City Attorney Secretary
Rev. 1/22.191
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EXHIBIT "A"
SC.Qpe of Services
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SCOPE OF SERVICES
MEDICAL PLAN
EXHIBIT A
Blue Cross/Blue Shield of FL (BCBS)
FY 2009/2010 City of Boynton Beach
Blue Options
Standard Plan 1748
I Provider Network I Network Blue
$5M
Maximum Benefit
BasIc, Preventive and Diagnostic
Open Access to Primary Care Physician/Specialist Yes
Test/Surgery Approval Required Yes
1M, GP, FP, Pedi OV Co-pay $10
Specialist OV Co-pay $20
Adult Well ness/Physical Exam Annual benefit Unlimited
Mammogram $0
Independ Clincial Lab Copay (Quest) $0
Independ Diagnostic Testing Fac. Co-pay $50
Prescription Co-pays $10/25/40
Mail Order Pharmacy 90 day supply/ 2 co pays $20/50/80
Expenses Subject to Deductiblel Coinsurance: Physician services
services outside office (surgery, anesthesia. radiology, pathology, ER)
Ambulance, DME, HHC, Therapy
Calendar year deductible (individual) $0 lnl $500 Out
Calendar year deductible (family) $0 in-network/$1500 non-network
Coinsurance (in-network after deductible) 0% nf
Physician services at hospital $0 dedI 0% coins
Physician services Ambulatory Surgical Ctr. $20
Coinsurance (out of-network after deductible) 40% + bb
Facility Billed Services: Varies by Hospital: Option 1 Hospitall Option 2
Hospital inpatient copay/admit $2501$500
Outpatient SurgeryfTest Copay $1001$200
Emergency Room Copay $501$100
Ambulatory Surgical Center Copay $50
Maximum out of Pocket: Inl Out of Network 5-$15001 $3000
(on ded/coins/non-rx co pays) f-$30001$6000
Note:
Official Schedule of Benefits will be provided at Open Enrollment.
Medicare Blue Scope of Services for retirees remains the same
MEDICAL
2009/2010 Monthly
Premium Rates
Blue Cross Blue Shield of Florida
EE Only 527.01
EE + Spouse 1,021.63
EE + Child(ren) 946.17
Family 1,175.26
share/HRlBenefits/RFP Medical Dental Vision/Rate Renewal Exhibit A Medical.xls
The City of Boynton Beach
City Clerk's Office
100 E BOYNTON BEACH BLVD
BOYNTON BEACH FL 33435
(561) 742-6060
FAX: (561) 742-6090
e-mail: prainitoj@ci.boynton-beach,fl.us
www.boynton-beach.org
MEMORANDUM
TO: Carol Doppler
Purchasing Agent
FROM: Judith A. Pyle, CMC
Deputy City Clerk
DATE: August 5, 2009
SUBJECT: R09-107 Group Benefits: Medical Claims Administrator (TPA)
Services anlor Fully Insured Plan, Fully Insured Dental and
Vision
Attached for your handling is the original agreement mentioned above and a copy of
the Resolution. Once the document has been executed, please return the original
document to the City Clerk's Office for further processing.
Thank you.
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Attachments (2)
C: Central File
S:\CC\WP\AFTER COMMISSION\Departmental Transmittals\2009\Carol Doppler R09-094.doc
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